Proximal Interphalangeal (PIP) foot joint fusion essentially fixes the joint and fuses the proximal and middle phalanx (toe bones) in a straightened or angled position. The PIP is the first joint of the small toes. An indication for surgery is when this joint has a fixed curve deformity, such as due to claw toe, hammer toe, or mallet toe deformities. The deformity may be producing enough pain or functional limitations to warrant surgery. The deformity generally develops gradually and thus becomes fixed in a bent position for a long period of time.
There are a variety of ways that a PIP foot joint fusion may be performed. The PIP foot joint may be approached either through a longitudinal or transverse incision on the top of the toe. Once the joint is opened up, a small segment of bone may be removed from either side of the joint, creating enough room for the joint to be realigned. The joint may then be fixated in a straightened or slightly angled position, either by way of a wire or an internal screw. Fixating the PIP foot joint may be performed in association with other procedures, such as a tendon transfer, to help keep the toe in the newly straightened position, as well as procedures to address underlying mechanical problems that may have caused the small toe deformities of the PIP foot joint.